Summary

Home-based (HB) rehabilitation is an alternative method of physiotherapy after ACL reconstruction to regain pre injury state level and to achieve a successful ligament reconstruction surgery especially during Covid pandemic period due to lockdown and restrictions.

Abstract

This is a prospective randomized and single-blinded study that was conducted over 2 years duration. 34 patients with ACL injury were randomized before surgery to either supervised physiotherapy (SP) or HB group. 27 patients completed rehabilitation (15 in SP;12 in HB). Patients were given an instructional video CD and equipment to perform rehabilitation at home. They were reviewed at 6-week, 3-month, and 6-month to evaluate knee range of motion (ROM), muscle strength and power by using Biodex dynamometer, knee stability by using KT-1000, and functional outcomes evaluated using Lysholm scoring. The main objective is to compare the outcome of ACL reconstruction between patients who completed a home-based rehabilitation program and patients who underwent a supervised physiotherapy rehabilitation program, for the first 6 months after surgery in terms of functional outcome, knee motion, graft laxity, and knee strength. The mean age for both groups was almost similar. 20 of the 27 patients were male. The patients were homogeneously distributed in both groups. All patients achieved the targeted range of motion except a patient in the SP group. Functional outcome scores improved at 6 months but were statistically insignificant (P value 0.652 at 3 months and 0.323 at 6 months). Knee laxity did not show any significant difference at 6 months (p: 0.371). Muscle strengths that were measured at 2 different speeds (180°/s and 300°/s) showed no significant difference as well as knee power after 6 months of home-based physiotherapy. A structured and video-facilitated HB rehabilitation was as effective as SP in achieving acceptable outcomes after 6 months post ACL reconstruction to be applied as the impact of mobility restriction during the Covid pandemic. Thus, it will provide a successful alternative method for the patients to return to the field post ACL reconstruction.